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Work environment affects hospital readmission rates

The provision of a good working environment for nursing staff reduces the risk of patients needing to go back to hospital by up to 10%, nurse academics have found.

Researchers from the University of Pennsylvania School of Nursing found that the environment in which nurses work had an effect on the treatment of patients.

Each year patients being readmitted to hospital costs Medicare more than $15 billion in the US, which could be saved with better care. And Medicare has responded by giving penalties to hospitals readmitting large numbers of patients.

The research looked at information from more than 200,000 nurses working at 412 hospitals based in California, New Jersey and Pennsylvania. The report claims that pensioners with pneumonia were 10% less likely to be readmitted within 30 days if they were treated in a hospital which provided staff with a positive working environment.

Hospitals which were considered to be good places to work also reduced the readmission of over-65s with heart failure by 7% and over-65s who had suffered from heart attacks by 6%.

Health policy expert Matthew McHugh, who was the lead author of the report, said the team’s findings indicated that if efforts were made to improve the working environments for nurses and cut their workloads then fewer patients with common medical issues would need to be readmitted to hospital.

He said recruiting more nurses could help the situation and although it would cost a lot of money, it would cut down on the amount which would need to be spent on replacing staff and training up new additions. He said it would also improve the outcomes for patients.

The research was paid for by the Robert Wood Johnson Foundation, the National Institute on Ageing, the National Institute on Nursing Research, Penn Institute on Urban Research, and the Frank Morgan Jones Fund.

 

Readers' comments (7)

  • what is a good working environment?

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  • Interesting piece of research. I read today about the toxic environment that was documented, examined and held as accountable for the Air France crash in....?2008 was it? Seems all too familiar to me.

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  • What we need are nurses that come into the profession for the right reasons. Watching Call the Midwife, made me realise why I came into the nursing profession all those years ago (1978) No amount of research will change the NHS at the moment. We need dedicate nursing staff with the skills to understand their role is to provide nursing care, to a high standard, show empathy and understanding, listen to our patients and most importantly care .

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  • Not just the nurses involved here though. Toxic environments include all areas, eg. Dr's, managers, receptionists, HCA's......
    Can't keep focussing in on nurses and expect a solution if missing the targets

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  • These research findings are not new - they appear to be a replication of longheld knowledge, and seem to be within the context of financial implications for readmissions.
    It is a good thing to highlight that the way organisations (wards/departments/hospitals) are run and what is expected from front-line clinicians have a direct effect on patient care.
    I disagree with Anon 4:28 anon - I too remember those days - the main difference was that we had role clarity, knew what was expected, and patient care was simpler. If the ethos within the organisation does not truly promote empathy and proper patient care (instead of just lip service) then new recruits will not develop those skills. More research in this country would provide evidence of this, as those in power try to ignore previous evidence.

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  • Re. comment made by Anon 4.28 p.m. What he/she fails to realise is that nursing is a PROFESSION, not a vocation. People enter it to carry out a professional tasks, which, yes, do include caring and empathy BUT we are not "bleeding hearts" here to do the job for next to nothing. We need a professional working environment and professional pay and conditions. Why should nurses expect to work "for the love of the job"? We don't describe policing, fire and rescue work, teaching or social works as vocations. They are respected professions, and are generally treated as such. If people want a vocation - go join a church. The working environment says a lot about how managment regard their employees, and of course it impacts on the way people carry out their work. For many nurses, the work environment is a disgrace. I am now community based, and would never want to go back to a ward-based job. My car has become my office for a large part of the day, but at least it's cleaner than most hospital wards.

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  • "What he/she fails to realise is that nursing is a PROFESSION, not a vocation. People enter it to carry out a professional tasks, which, yes, do include caring and empathy BUT we are not "bleeding hearts" here to do the job for next to nothing. We need a professional working environment and professional pay and conditions. Why should nurses expect to work "for the love of the job"? "

    Hmmm. Is nursing a profession? Probably not in strict terms. But it seems all this poster cares about is the money so possibly lacks any insight....
    Given that plumbers, footballers, and even estate agents claim to be professionals I might even prefer to be seen as a vocational worker as it sets me apart from groups with whom I believe I have little in common!
    I am happy to care and would be happy to be assessed as a decent human being - much happier than earning lots of dosh for pushing paper round a desk. I need to earn a living wage but when I started nursing I earned £30 per week and never expected to be wealthy. However, I did [and still do] a really slick job caring for sick people and have worked in psychiatry, CICU, PICU, and paediatrics and had a great time during my career.
    Sadly, as the environment has become 'professional' much of the joy has been sucked away....
    I guess if you are the sort of person who only thinks of money and enjoys spending half your life in a care rather than caring for real people you won't even begin to see how those oldies like myself can still love being at the sharp end...

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